Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial

Adam B Lewin; Jennifer M Park; Anna M Jones; Erika A Crawford; Alessandro S De Nadai; Jessie Menzel; Elysse B Arnold; Tanya K Murphy; Eric A Storch

doi:10.1016/j.brat.2014.02.001

Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial

Behav Res Ther. 2014 May:56:30-8. doi: 10.1016/j.brat.2014.02.001. Epub 2014 Mar 2.

Authors

Adam B Lewin¹, Jennifer M Park², Anna M Jones², Erika A Crawford³, Alessandro S De Nadai², Jessie Menzel², Elysse B Arnold⁴, Tanya K Murphy⁵, Eric A Storch⁶

Affiliations

¹ Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA. Electronic address: alewin@health.usf.edu.
² Department of Psychology, University of South Florida, USA.
³ Department of Pediatrics, University of South Florida, USA.
⁴ Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA.
⁵ Department of Pediatrics, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA.
⁶ Department of Pediatrics, University of South Florida, USA; Department of Psychology, University of South Florida, USA; Department of Psychiatry & Behavioral Neurosciences, University of South Florida, USA.

PMID: 24657310
DOI: 10.1016/j.brat.2014.02.001

Abstract

Aims: To examine the feasibility, acceptability and preliminary efficacy of family-based exposure/response prevention therapy (E/RP) versus treatment as usual (TAU) in a cohort of very young children with early onset obsessive-compulsive disorder (OCD).

Methods: Thirty-one children ages 3-8 years (M = 5.8 years) with a primary diagnosis of OCD were randomized to E/RP or TAU. The E/RP condition received 12 sessions of family-based E/RP twice weekly over 6 weeks. Families were assessed at baseline, post-treatment, 1-month and 3-month follow up. The Children's Yale Brown Obsessive Compulsive Scale and Clinical Global Impression served as primary outcome measures.

Results: A large group effect emerged in favor of the E/RP group (d = 1.69). Sixty-five percent of the E/RP group was considered treatment responders as compared to 7% in the TAU group. Symptom remission was achieved in 35.2% of the E/RP group and 0% of the TAU group. There was no attrition and satisfaction was high; gains were maintained at 3 months.

Conclusions: Even amongst children as young as 3 years, developmentally tailored E/RP is efficacious and well-tolerated in reducing OCD symptoms. Key adaptations for younger children include extensive parent involvement, targeting family accommodation, and frequent meetings while delivering a full course of E/RP.

Clinicaltrialsgov identifier: NCT01447966 http://clinicaltrials.gov/ct2/show/NCT01447966?term=ocd+and+st+petersburg&rank=1.

Keywords: Accommodation; Cognitive therapy; Exposure-response prevention; OCD; Preschool; Very young children.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Age Factors
Behavior Therapy*
Child
Child, Preschool
Combined Modality Therapy
Family Therapy*
Female
Humans
Implosive Therapy*
Male
Obsessive-Compulsive Disorder / therapy*
Pilot Projects
Psychiatric Status Rating Scales

Associated data

ClinicalTrials.gov/NCT01447966